It's amazing how much time we parents spend inspecting our babies' nappies! We tend to worry that our baby's stool is the wrong colour or texture, or that she's passing stool too often,or not enough. However, what's normal for your baby will depend on:

  1.  how old she is
  2.  whether she's breastfed or bottle-fed
  3.  whether she's started solids

Your baby's stool will change as she develops from a newborn through her first year. They may also change from one day to the next! You'll soon be able to tell what's usual for her.How often should my baby pass stool?

How often should my baby pass stool?

There are no hard and fast rules. In the early months it will depend on whether you're breastfeeding or formula feeding your baby. Breastfed babies who are not on solids may pass stool four times a day or more, or only once every seven days. All variations between these extremes is considered normal as long as the stools are soft and your baby is gaining enough weight.Formula-fed babies normally need to poop every day to feel comfortable and avoid constipation.Lots of babies strain and cry a bit when they poo, but it doesn't mean there's a problem. As long as your baby's stool is soft and easy to pass, there's no cause for concern.

What will my newborn's stool be like?

For the first couple of days after the birth, your baby will pass meconium. This is made up of mucus, amniotic fluid, and everything your baby has ingested while she was in your uterus(womb).Meconium is greeny-black in colour, and has a sticky, tar-like texture. It may be difficult to wipe off that tiny bottom, but its appearance is a good sign that your baby's bowels are working normally. HURRAY 

What will my baby's stool be like if I am breastfeeding?

Your colostrum acts as a laxative, helping to push meconium out of your baby's system. Once your milk comes in, after about three days, your baby's stool will gradually change. It will be:

  1. Lighter in colour, changing from a greenish-black to bright or mustard yellow. 
  2. This yellow stool may smell slightly sweet.
  3.  Loose in texture.
  4.  The stool may seem grainy at times, curdled at others.

In the early weeks, your baby may pass stool during or after every feed. On average, she might dirty four nappies or more a day in the first week. This will settle down and her bowels will work out their own routine. You may find she then passes stool at a similar time each day. Your baby's routine may change:

  1.  when you introduce solids
  2.  if she is feeling unwell
  3. when she starts to take fewer feeds.

What will my baby's stool be like if I amformula feeding?

If you are formula feeding your baby, her stool may be different to a breastfed baby's. You may notice they are:

  1.  Bulkier in texture than a breastfed baby's (a bit like the texture of toothpaste). This is because formula milk can't be digested as fully as breastmilk.
  2.  Pale yellow or yellowish-brown in colour.
  3.  Strong-smelling, more like an adult's.

Bottle-fed babies are more prone to constipation than breastfed babies. Visit to your doctor if  you feel your baby has a problem.

What will my baby's stool be like when she start solids?

Starting your baby on solids will have a dramatic effect on her stool. You'll find that her stoolis affected by the foods she eats. If you feed her pureed carrot, the contents of her next nappy will be bright orange.You may find fibre-rich foods, such as raisins or baked beans, pass straight through your baby and end up in her nappy undigested. This will change when she gets older and is able todigest fibre more efficiently.As she moves on to a wide variety of foods, your baby's stool will become thicker, darker and a lot more smelly.

What sort of potty is not normal?

Diarrhoea: You can recognise the signs of diarrhoea if:

  1.  your baby's stool is very runny
  2.  she is passing stool more often, or passing larger amounts than normal
  3. the stool is explosive or spurts out of her bottom
  4. there is blood in her stool

If you are breastfeeding your baby, she is less likely to suffer from diarrhoea. This is because your milk helps to prevent the growth of the bacteria that cause it.Bottle-fed babies are more prone to infection, which is why it's so important to sterilise equipment and always wash your hands thoroughly.If your baby is teething her stool may be looser than normal but it should not cause diarrhoea.If your baby has diarrhoea don't assume that her teething is the cause, it's more likely to be an infection. 

In an older baby, diarrhoea can also be a sign of severe constipation. Fresh stool may be leaking out past a blockage of hard stool.If the diarrhoea does not clear up after 24 hours, take your baby to the doctor.

Constipation: Many babies turn bright red and push hard when they pass stool. This is normal. Constipation on the other hand, is when:

  1.  Your baby seems to have real difficulty in moving her bowels.
  2.  Her stools are small and dry. Alternatively they may be large and hard.
  3. Her tummy feels tight to touch.
  4.  Her stools have fresh blood in them. This can be caused by tiny cracks in the skin,called anal fissures, caused by passing hard stool.

Breastfed babies don't tend to suffer as much from constipation as bottle-fedbabies. Breastmilk contains all the right nutrients to keep their stool soft.Making formula milk with too much powder can lead to constipation. Always follow the instructions when making up a bottle.Take your baby to the doctor if she's constipated, particularly if you notice blood in her stool.

Green stool: Green stool can be a sign that your baby is taking in too much lactose (the natural sugar found in milk). This can happen if she feeds often, but doesn't get the rich hindmilk at the end of the feed to fill her up. Make sure your baby finishes feeding from one breast before your offer her your other one. It may also be caused by:

  1.  The brand of formula you're using. Some can make your baby's poo dark green.
  2. A food sensitivity.
  3.  Side effects of medication (iron supplements can make your baby's stool dark).
  4. A stomach bug.
  5.  Your baby's feeding routine.

If the symptoms last longer than 24 hours, visit your doctor.

Very pale poo: This can be a sign of jaundice. Newborn jaundice never makes a baby's stool pale. Pale stools is an important sign of liver disease so you should mention it to your doctor even if she doesn't look jaundiced to you. In older children, too much milk intake or certain infections can also lead to pale stools.

Streaks of blood: Your baby's stool may have flecks of blood if she's constipated or if her intestines are irritated by an infection or allergy. Always get any blood in your baby's poo checked out by your doctor.


DR. POONAM M SAMBHAJI

CHILD AND NEWBORN SPECIALIST